Individual provider Active NPI

Steven W Merrell, MD

  • Vascular Surgery Physician
  • Murray, UT
National Provider Identifier
1063452050
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
171679-1205 Issued in UT
Practice address
5323 S. Woodrow Street
#102
Murray, UT 84107
Phone
(801) 713-1010
Fax
(801) 713-0665
NPI assigned
Jun 7, 2006
Last updated
May 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 171679-1205 UT Primary

Addresses

Primary practice location

5323 S. Woodrow Street
#102
Murray, UT 84107

Mailing address

5444 Green St
Murray, UT 84123-5632
Phone (801) 713-1010

Other identifiers 1

IdentifierTypeStateIssuer
07831MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000637 UT Practitioner - Vascular Surgery 5294637898 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
171679-1205UTMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2017 Accepting new patients
Mountain Medical Physician Specialists PC Vascular Surgery CurrentSince Aug 1, 2002 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

296 E 3900 S
Salt Lake Cty, UT 84107
Phone (801) 262-8120

370 Ninth Ave
#208
Salt Lake Cty, UT 84103
Phone (801) 321-1000

5770 S 250 E
Ste 360
Salt Lake Cty, UT 84107
Phone (801) 314-1000

1486 E Skyline Dr
South Ogden, UT 84405
Phone (801) 475-4552

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1063452050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-713-1010",
            "fax_number": "801-713-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 S. WOODROW STREET",
            "address_2": "#102",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-713-1010",
            "fax_number": "801-713-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "STEVEN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "171679-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07831",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.